Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA; Department of Intensive care, University Hospital of Guadeloupe, Pointe-à-Pitre, France.
Division of Clinical Microbiology, Mayo Clinic, Rochester, MN, USA.
Diagn Microbiol Infect Dis. 2021 Oct;101(2):115448. doi: 10.1016/j.diagmicrobio.2021.115448. Epub 2021 Jun 5.
16S ribosomal RNA (rRNA) gene PCR followed by next-generation sequencing (NGS) was compared to culture of sonicate fluid derived from total elbow arthroplasty for periprosthetic joint infection (PJI) diagnosis. Sonicate fluids collected from 2007 to 2019 from patients who underwent revision of a total elbow arthroplasty were retrospectively analyzed at a single institution. PCR amplification of the V1-V3 region of the 16S rRNA gene was performed, followed by NGS using an Illumina MiSeq. Results were compared to those of sonicate fluid culture using McNemar's test of paired proportions. Forty-seven periprosthetic joint infections and 58 non-infectious arthroplasty failures were studied. Sensitivity of targeted NGS was 85%, compared to 77% for culture (P = 0.045). Specificity and positive and negative predictive values of targeted NGS were 98, 98 and 89%, respectively, compared to 100, 100 and 84%, respectively, for culture. 16S rRNA gene-based targeted metagenomic analysis of sonicate fluid was more sensitive than culture.
16S 核糖体 RNA(rRNA) 基因 PCR 联合下一代测序(NGS) 与关节镜冲洗液培养在全肘人工关节置换术后假体周围关节感染(PJI) 的诊断中进行了比较。对 2007 年至 2019 年间在一家医疗机构接受全肘翻修术的患者的关节镜冲洗液进行了回顾性分析。对 16S rRNA 基因的 V1-V3 区进行 PCR 扩增，然后使用 Illumina MiSeq 进行 NGS。采用配对比例 McNemar 检验比较 PCR 扩增和冲洗液培养的结果。共研究了 47 例假体周围关节感染和 58 例非感染性关节置换失败。靶向 NGS 的敏感性为 85%，而培养的敏感性为 77%(P=0.045)。与培养相比，靶向 NGS 的特异性、阳性预测值和阴性预测值分别为 98%、98%和 89%。基于 16S rRNA 基因的靶向宏基因组分析比培养更敏感。
